RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME: XXXXXXXXXX.  	CASE:  PD-2017-01053
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20080825

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Motor Transport Operator, medically separated for “right groin pain” with a disability rating of 0%.  

CI CONTENTION:  The CI requested review of additional conditions not identified by the Medical Evaluation Board (MEB) and Physical Evaluation Board (PEB) and two conditions identified by the MEB and PEB.  The complete submission is at Exhibit A.  

SCOPE OF REVIEW:  The panel’s scope of review is defined in DoDI 6040.44.  It is limited to review of disability ratings assigned to those conditions determined by the PEB to be unfitting for continued military service, and when specifically requested by the CI, those conditions identified by the MEB, but determined by the PEB to be not unfitting or non-compensable.  Any conditions outside the panel’s defined scope of review, and any contention not requested in this application, may remain eligible for future consideration by the Board for Correction of Military Records.  The panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections when appropriate.  The panel’s assessment of the PEB rating determination is based on review of medical records and all available evidence relevant to application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards for the unfitting medical condition(s) at the time of separation.  The panel has neither the role nor the authority to compensate for post-separation progression or complications of service-connected conditions; that role and authority is granted by Congress to the Department of Veterans Affairs, which operates under a different set of laws.  The panel gives consideration to VA evidence, particularly within 12 months of separation, but only to the extent that it reasonably reflects the severity of disability at the time of separation.  

RATING COMPARISON:  

SERVICE PEB - 20080701	VARD - 20090422	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Right Groin Pain	8799-8730	0%	Nerve Damage, Right Groin	8530	0%	20090127	
Left Ankle Tibiofibular Ligament Sprain	Not Unfitting	Left Ankle Sprain	5271	Deferred	20090127	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  60%	

ANALYSIS SUMMARY:  

Right Groin Pain.  According to the service treatment record and MEB narrative summary (NARSUM), the CI was born with a right inguinal hernia condition.  In 2005, the CI underwent a right inguinal hernia repair via laparoscopy with insertion of a Teflon mesh prior to joining the Army.  He completed basic training without incident.  However, 7 months after his inguinal hernia surgery, he developed right groin pain after loading pallets, climbing into and out of a truck and changing tires.  Treatment was not sought until after his deployment in July 2007.  In October 2007, he developed knife-like right groin pain while doing sprints as part of physical training.  An ultrasound of the lower abdomen was normal.  Surgical re-intervention was not an option.  The CI’s painful condition was refractory to conservative management and his diagnosis remained as right groin pain.    

The 10 June 2008 MEB NARSUM examination, one month prior to separation, noted complaints of a constant stinging/throbbing right groin pain that was aggravated by walking with long strides, climbing more than 12 stairs, running, jumping, carrying more than 30 pounds, bending over to tie his shoes or doing sit-ups.  The focused physical examination (PE) revealed tenderness about the right groin without the presence of enlarged lymph nodes or underlying masses.  His gait demonstrated a “slight limp” that favored his right side.  

At the 27 January 2009 VA Compensation and Pension (C&P) examination, 5 months after separation, the CI’s case history was summarized without noting additional physical complaints.  The PE revealed right-sided groin tenderness.  The CI’s gait and posture were normal.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the right groin pain 0%, analogously coded 8799-8730 (neuralgia; illio‑inguinal nerve), citing pain that prevented full duty performance.  Utilizing VASRD code 8530 (paralysis; illio-inguinal nerve), the VA also rated the right-sided groin condition at 0%, based on the C&P examination, citing a “mild” degree of impairment.  

Panel members first deliberated on the most appropriate and beneficial coding to represent the CI’s condition.  Given his previous surgical history, the present level of physical activity and persistent painful symptoms in the groin clearly indicated anatomical involvement of the right Ilio-inguinal nerve and therefore, VASRD codes of either 8530 (used by VA) or 8730 (used by PEB) were considered.  VASRD §4.124a has only two possible ratings for impairment (paralysis) of this nerve; 0% (mild or moderate) or 10% (severe to complete paralysis), which equates to the maximum rating if the condition was coded as neuralgia of the same nerve.  Either way, panel members agreed that although the CI persistently voiced pain and objectively demonstrated local tenderness about the groin, his overall functional ability was not impaired to any level above “mild” or “moderate,” which equates to a 0% rating.  Therefore, after due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded there was insufficient cause to recommend a change in the PEB’s adjudication for the right groin pain condition. 

Contended PEB Condition:  Left Ankle Tibiofibular Ligament Sprain.  The panel’s main charge is to assess the fairness of the PEB’s determination that the contended condition was not unfitting.  The contended condition was not profiled or implicated in the commander’s statement and did not fail retention standards.  There was no performance-based evidence from the record that the condition significantly interfered with satisfactory duty performance at or near separation.  After due deliberation, the panel concluded there was insufficient cause to recommend a change in the PEB’s fitness determination for the contended condition, so no additional disability rating is recommended.  

BOARD FINDINGS:  In the matter of the right-sided groin pain condition and IAW VASRD §4.124a, the panel recommends no change in the PEB adjudication.  In the matter of the contended left ankle condition, the panel recommends no change from the PEB’s determination as not unfitting.  There are no other conditions within the panel’s scope of review for consideration.  Therefore, the panel recommends no modification or re-characterization of the CI’s disability and separation determination.  

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Dear XXXXXXXXXX:

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found your separation disability rating and your separation from the Army for disability with severance pay to be accurate.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed), and I accept its recommendation.  I regret to inform you that your application to the DoD PDBR is denied.  

	This decision is final.  Recourse within the Department of Defense or the Department of the Army is exhausted; however, you have the option to seek relief by filing suit in a court of appropriate jurisdiction.